191\u2005Radiological endovascular embolization of small pelvic arteries in patients with complicated uterine cervix cancer: single-center experience in belarus

Abstract

Objectives To conduct the efficacy of radiological endovascular embolization of small pelvis arteries in patients with locally advanced and recurrent uterine cervix cancer (UCC) complicated with hemorrhage. Methods 81 patients were included: 68 (84%) primary patients with locally advanced UCC and 13 (16%) – with UCC recurrences, who underwent radiological endovascular occlusion of small pelvis arteries regarding bleeding from tumor. Results Distribution of primary patients according to FIGO stages: IIB stage – in 4 (6%), IIIB – in 44 (65%), IV – in 20 (29%). In the result of the procedure hemorrhage was stopped in 76 (94%) patients. After successful conduction of radiological endovascular hemostasis in 68% (46 of 68) of primary UCC patients’ antineoplastic treatment was performed, according to the radical program in full – in 43% (29 of 68) of cases. Survival of 22 (32%) patients who was not treated further, and 46 (68%) patients who continued the treatment was significantly differed. 1-year adjusted survival (AS) was 15.2% (SE 8.1%) and 53.5% (SE 7.4%), respectively. No patient survived to 5 years in the first subgroup, in the second subgroup a 5-year AS was 24.0% (SE 6.8%), median AS for the first subgroup was 5.4 months, for the second – 12.8 months (p <0.001). Conclusions Arterial embolization of pelvic vessels is an effective method of arrest of hemorrhage in patients with locally advanced and recurrent UCC in 94% of cases. Conduction of this procedure in primary patients in case of complicated locally advanced UCC allows to perform special antitumor treatment in 68% of cases.